Healthcare Provider Details

I. General information

NPI: 1376730523
Provider Name (Legal Business Name): CAROLYN ANN SCHULTE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 12/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W WILLIAM CANNON DR SUITE 409
AUSTIN TX
78745-5257
US

IV. Provider business mailing address

5000 BEE CAVE RD SUITE 204
AUSTIN TX
78746-5254
US

V. Phone/Fax

Practice location:
  • Phone: 512-852-8434
  • Fax: 512-852-8435
Mailing address:
  • Phone: 512-329-6617
  • Fax: 512-329-6772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1162072
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: